Opioid overdoses jumped 30% from July 2016 to September 2017 in 52 areas across 45 states, the Centers for Disease Control and Prevention said Tuesday. Opioid overdoses increased in the Midwestern region over the same period and spiked 54% in the largest cities in the country.

These figures provide an “early warning system” for health departments to coordinate a response, the CDC report said. “This fast-moving epidemic does not stay within state and county lines,” it added.